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Fasting in healthy, euthyroid people causes reduced T3 and elevated rT3, although TSH is usually unchanged. [3] [5] [10] Even moderate weight loss can lower T3. [2] This may be primarily via reduced levels of leptin (the satisfaction hormone). Low leptin levels can downregulate hypothalamic TRH neurons and cause a reduction in TSH.
Free T4, total T3 or both are elevated and serum TSH is below normal in hyperthyroidism. If the hyperthyroidism is mild, only serum T3 may be elevated and serum TSH can be low or may not be detected in the blood. [14] Free T4 levels may also be tested in patients who have convincing symptoms of hyper- and hypothyroidism, despite a normal TSH.
White dog shaker syndrome causes full body tremors in small, white dog breeds. It is most common in West Highland White Terriers, Maltese, Bichons, and Poodles. [6] Wobbler disease (cervical instability) is a condition of the cervical vertebrae that causes an unsteady gait and weakness in dogs.
Early attempts at titrating therapy for hypothyroidism proved difficult. After hypothyroidism was found to cause a lower basal metabolic rate, this was used as a marker to guide adjustments in therapy in the early 20th century (around 1915). [82] However, a low basal metabolic rate was known to be non-specific, also present in malnutrition. [82]
Low-T3 syndrome and high-T3 syndrome: Consequences of step-up hypodeiodination, e.g. in critical illness as an example for type 1 allostasis, [20] or hyperdeiodination, as in type 2 allostasis, including posttraumatic stress disorder. [12] Resistance to thyroid hormone: Feedback loop interrupted on the level of pituitary thyroid hormone receptors.
Around the world, the most common cause of congenital iodine deficiency syndrome (endemic cretinism) [1] is dietary iodine deficiency. Iodine is an essential trace element, necessary for the synthesis of thyroid hormones. Iodine deficiency is the most common preventable cause of neonatal and childhood brain damage worldwide. [11]
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The syndrome can present with variable symptoms, even between members of the same family harboring the same mutation. [1] Typically most or all tissues are resistant to thyroid hormone, so despite raised measures of serum thyroid hormone the individual may appear euthyroid (have no symptoms of over- or underactivity of the thyroid gland).